USA Dentac

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

7547 Issued in NC

Legal business name

USA DENTAC

Practice address

2817 Reilly St
Fort Bragg, NC 28310-7324

Phone

(910) 643-2196

NPI assigned

Aug 31, 2016

Organization subpart

Yes

Parent organization

123456As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charles Bernatovitz, BSD

Title

HSS

Phone

(910) 643-2196

Specialties & licenses 1

Addresses

Part of

Community Care Services

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christa Fontaine

  • Dental Hygienist
  • Fort Bragg, NC
  • NPI 1114473998
  NPD (past)
• Yvonne Reid

  • Dental Assistant
  • Fort Bragg, NC
  • NPI 1609322551
  NPD (past)
• Kirk Charles Goebel, D.D.S.

  • General Practice Dentistry
  • Savannah, GA
  • NPI 1386055325
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1568918340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 RIELLY ROAD",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "28310",
            "telephone_number": "910-643-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 REILLY ST",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107324",
            "telephone_number": "910-643-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USA DENTAC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "123456",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "BERNATOVITZ",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "HSS",
        "authorized_official_telephone_number": "910-643-2196",
        "authorized_official_credential": "BSD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NC",
            "license": "7547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derek Culhane Underhill, PHARM.D., M.B.A.
• Ashley Lynne Urick, M.D.
• Mauricio Carlos Urrutia, MD
• US Army- Womack Army Medical Center
• USA Dentac
• USA Dentac HQS
• Gabriel Valdez
• Nicole Vallee, RD, LDN
• Keri Vampola, LCSW
• Ashtyn Van Horn

• Dental Clinic/Center in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Dental Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.